Cowhage (Mucuna pruriens) seeds have been used in traditional Ayurvedic medicine to treat Parkinson's disease. This traditional use is supported by laboratory analysis that shows cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs that is a precursor to dopamine. In a few clinical trials in Parkinson's disease patients, three cowhage treatments yielded positive results. However, more research should be conducted to elucidate the treatment that is the most effective. In addition, cowhage seeds have nutritional quality comparable to soy beans and other conventional legumes, but several antinutritional/antiphysiological compounds prevent these seeds from being used as a food source.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Traditional Ayurvedic medicine and preliminary evidence suggests that cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs. Cowhage treatments have yielded positive results in early studies. However, more research should be conducted to determine the treatment that is the most effective.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

There is no proven effective dose for cowhage in adults. For Parkinson's disease, 15 and 30 grams of a cowhage preparation has been taken by mouth for a week. Sachets containing a derivative of cowhage, called HP-200, have also been used.

Children (younger than 18 years)

There is no proven safe or effective dose for cowhage in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to cowhage (Mucuna prurient) or its constituents. Hairs on cowhage flowers and pods can cause severe pruritus (itching).

Side Effects and Warnings

Few adverse effects have been reported for cowhage. In one study in Parkinson's disease patients, a derivative of Mucuna prurient caused mild adverse effects that were mainly gastrointestinal in nature. Cowhage has also caused acute toxic psychosis, which may be due to its levodopa content. Use cautiously in patients with Parkinson's disease and/or taking levodopa, dopamine, dopamine agonists, dopamine antagonists, or dopamine reuptake inhibitors as cowhage seeds contain the dopamine precursor levodopa.

Hairs on cowhage flowers and pods can cause severe pruritus (itching), and have also been used to artificially induce pruritus.

Use cautiously in patients taking monoamine oxidase inhibitors (MAOIs), as the levodopa in cowhage seeds may interact and cause high blood pressure.

Use cautiously in patients taking anticoagulants (blood thinners) or with diabetes or hypoglycemia, due to the potential for additive effects.

Avoid in patients with psychosis or schizophrenia, as cowhage has caused acute toxic psychosis.

Avoid in pregnant or breastfeeding patients as cowhage may inhibit prolactin secretion.

Pregnancy and Breastfeeding

Cowhage is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Two early studies indicate that cowhage may inhibit prolactin secretion.

The leaves of Mucuna pruriens may dose-dependently prolong blood clotting. Caution is advised in patients taking drugs that also increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Use cautiously in patients taking diabetes medications as cowhage may alter blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely be a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Cowhage seeds contain levodopa, which may cause high blood pressure when taken with monoamine oxidase (MAO) inhibitors. Caution is advised in patients with hypertension (high blood pressure) or taking medication that alters blood pressure due to possible additive effects.

In a case report, cowhage caused an outbreak of acute toxic psychosis. Caution is advised in patients with mental illnesses.

The leaves of Mucuna pruriens may dose-dependently prolong blood clotting. Use cautiously in patients with bleeding disorders or taking other blood thinning herbs or supplements due to a possible increase in the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

In a case report, cowhage caused an outbreak of acute toxic psychosis. Use cautiously in patients with mental illnesses.

Ayahuasca (Banisteriopsiscaapi) is a known MAO inhibitor; cowhage seeds contain levodopa, which may cause high blood pressure when taken with MAO inhibitors. Use cautiously in patients with hypertension (high blood pressure) or taking other herbs or supplements, such as ayahuasca, that alter blood pressure.

Ergot (Claviceps purpura) has known dopamine agonist activity; cowhage seeds contain levodopa, which is a precursor to dopamine. Use cautiously in patients with mental illnesses, such as depression, as the combination of cowhage and ergot may result in additive effects.

Jimson weed (Datura stramonium) is a known anticholinergic; cowhage seeds contain levodopa, which may interact with anticholinergics. Use cautiously in patients with Parkinson's disease as the combination of cowhage and Jimson weed may result in additive effects.

Fava beans (Vicia faba) contain levodopa, as do cowhage seeds. Use cautiously with fava beans due to possible additive effects.

Cowhage may alter blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking herbs or supplements that affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.